Hypertension in Incarcerated Women.

Health Promotion inHypertension in Incarcerated Women.

A random survey of California prison inmates found that women had a high incidence of hypertension.Background information and the significance to the communitys health:Compared to a survey taken in 201112, rates of high blood pressure and diabetes rose among prisoners increased at a rate of 1.5 times the rate in 2004. Incarcerated women are found to have a prevalence of 26.9 % of hyper tension than the general population at 13.9 %.Incarcerated women are found to be more likely obese and/or morbidly obese than their male counterparts. Incarcerated women report having higher incidence than males of having a chronic health condition, the most frequently reported being hypertension. The health care team at a small local womens prison has asked a group of nurses to assist them in developing a health promotion/health teaching plan for screening and educating women on hypertension.

Learning Needs Assessment:

Assessing the ability of inmates to retain and understand health education received. Such as Language barriers, cultural disparities, Educational level, and Learning disabilities. Assessing readiness to participate in health behavior modification. Assessing for barriers (perceived/actual)

The community model selected is the PRECEDE-PROCEDE model of health promotion. 1.Learn the perceptions on needs and quality of life.2.Epidemiologic assessment 3.Education/ecological assessment 4.Administration policy assessment 5.Implementation 6.Outcome and evaluation/modifications.

Health Promotion/Health Education Plan:Patient Goal: Control BP and reduce cardiovascular disease (CVD) risk factors.3 behavioral outcomes that will indicate that the teaching plan has been successful:1. Smoking cessation [ nicotine increases vascular constriction = contributes to HPTN]2. Weight reduction/maintain ideal BMI3. Reduce dietary sodium to 2300mg/Day [reduce the work load of the heart by retaining less fluid]

Research and/or Other Evidence:Maruschak, L. M., Berzofsky, M., & Unangst, J. (2015). Medical Problems of State and Federal Prisoners and Jail Inmates, 201112. U.S. Department of Justice Office of Justice Programs Bureau of Justice Statistics. Addresses current health statistics of nations incarcerated.Bingswanger, I.A., (2010). Chronic Medical Diseases among Jail and Prison Inmates. Society of Correctional Physicians.Compares chronic illness of incarcerated population against general population.Ajinkya, J., (2013) Rethinking How to Address the Growing Female Prison Population. Center for American Progress. Addresses diversity in prisons, health disparities and poverty as underlying causes.

Evaluation method:Keep a BP log and monitor BP regularly (weekly, monthly, etc) and track trend. Keep a food journal and measure BMI / track weight loss while participating in exercise program such as 30 mins of walking 5x day. Describe feelings while participating in program.

Way forward

Address underlying causes in the community to prevent re-entry into prison system.Improve womens equality in health. Correctional reform in regards to the relationship between women of color and health disparities.

ReferencesMaruschak, L. M., Berzofsky, M., & Unangst, J. (2015). Medical Problems of State and Federal Prisoners and Jail Inmates, 201112. U.S. Department of Justice Office of Justice Programs Bureau of Justice StatisticsBingswanger, I.A., (2010). Chronic Medical Diseases among Jail and Prison Inmates. Society of Correctional Physicians.Ajinkya, J., (2013) Rethinking How to Address the Growing Female Prison Population. Center for American Progress. Mighty Nurse (2013) Correctional Facility Nursing Retrieved from http://minoritynurse.com/correctional-facility-nursing/